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MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: North Dakota Section B2. Use of Electronic Data Sources Non-Financial: Electronic Data Source To Be Used (Y/N) Social Security Number Citizenship Immigration Status Residency Age/DOB Pregnancy Household Composition Caretaker Relative Medicare Application for other Benefits Other Data Source Used at Applicatio n (Y/N) Data Source Used at Renewal (Y/N) Data Source Used Post- Enrollme nt (Y/N) If Used for Post- Enrollment Frequency Used (i.e. monthly, quarterly) Comments 1. Social Security Administration (SSA) YES YES YES NO NO YES NO NO NO YES NO NO YES YES YES Other (specify in comments) Used post-enrollment when system notifies of changes related to Medicare. If a discrepancy is identified this source can be used for Application for other Benefits. 2. Department of Homeland Security (DHS) - SAVE YES NO NO YES NO NO NO NO NO NO NO NO YES YES NO Used at Renewal for individuals about to meet the 5-year bar or whose status is subject to change. 3. Vital Statistics YES NO YES NO NO NO NO NO NO NO NO NO YES YES NO Uses data source for citizenship as a back- up to SSA, and caretaker relative and household composition if needed to resolve inconsistencies with other data sources or if the state is made aware of conflicting information. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B2 - Use of Electronic Data Sources, Non-Financial 6